medical essays-第42章
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mends； as internal medicines； most of the substances commonly used as fertilizers of the soil。 His 〃Album Graecum〃 is best left untranslated； and his 〃Zebethum Occidentale〃 is still more transcendentally unmentionable except in a strange dialect。 It sounds odiously to us to hear him recommend for dysentery a powder made from 〃the sole of an old shoe worn by some man that walks much。〃 Perhaps nobody here ever heard of tying a stocking； which had been worn during the day； round the neck at night for a sore throat。 The same idea of virtue in unlovely secretions！ ＇The idea is very ancient。 〃Sordes hominis〃 〃Sudore et oleo medicinam facientibus。〃 Plin。 xxviii。 4。＇
Even now the Homoeopathists have been introducing the venom of serpents； under the learned title of Lachesis； and outraging human nature with infusions of the pediculus capitis； that is； of course； as we understand their dilutions； the names of these things； for if a fine…tooth…comb insect were drowned in Lake Superior； we cannot agree with them in thinking that every drop of its waters would be impregnated with all the pedicular virtues they so highly value。 They know what they are doing。 They are appealing to the detestable old superstitious presumption in favor of whatever is nauseous and noxious as being good for the sick。
Again； we all occasionally meet persons stained with nitrate of silver； given for epilepsy。 Read what Dr。 Martin says； about the way in which it came to be used； in his excellent address before the Norfolk County Medical Society； and the evidence I can show； but have not time for now； and then say what you think of the practice which on such presumptions turns a white man as blue as the double…tattooed King of the Cannibal Islands！ ＇Note A。＇
If medical superstitions have fought their way down through all the rationalism and scepticism of the nineteenth century； of course the theories of the schools； supported by great names； adopted into the popular belief and incorporated with the general mass of misapprehension with reference to disease； must be expected to meet us at every turn in the shape of bad practice founded on false doctrine。 A French patient complains that his blood heats him； and expects his doctor to bleed him。 An English or American one says he is bilious； and will not be easy without a dose of calomel。 A doctor looks at a patient's tongue； sees it coated； and says the stomach is foul； his head full of the old saburral notion which the extreme inflammation…doctrine of Broussais did so much to root out； but which still leads； probably； to much needless and injurious wrong of the stomach and bowels by evacuants； when all they want is to be let alone。 It is so hard to get anything out of the dead hand of medical tradition！ The mortmain of theorists extinct in science clings as close as that of ecclesiastics defunct in law。
One practical hint may not be out of place here。 It seems to be sometimes forgotten； by those who must know the fact； that the tongue is very different； anatomically and physiologically； from the stomach。 Its condition does not in the least imply a similar one of the stomach； which is a very different structure； covered with a different kind of epithelium； and furnished with entirely different secretions。 A silversmith will； for a dollar； make a small hoe； of solid silver； which will last for centuries； and will give a patient more comfort； used for the removal of the accumulated epithelium and fungous growths which constitute the 〃fur；〃 than many a prescription with a split…footed Rx before it； addressed to the parts out of reach。
I think more of this little implement on account of its agency in saving the Colony at Plymouth in the year 1623。 Edward Winslow heard that Massasoit was sick and like to die。 He found him with a houseful of people about him； women rubbing his arms and legs； and friends 〃making such a hellish noise〃 as they probably thought would scare away the devil of sickness。 Winslow gave him some conserve； washed his mouth； scraped his tongue； which was in a horrid state； got down some drink； made him some broth； dosed him with an infusion of strawberry leaves and sassafras root； and had the satisfaction of seeing him rapidly recover。 Massasoit； full of gratitude； revealed the plot which had been formed to destroy the colonists； whereupon the Governor ordered Captain Miles Standish to see to them； who thereupon； as everybody remembers； stabbed Pecksuot with his own knife； broke up the plot； saved the colony； and thus rendered Massachusetts and the Massachusetts Medical Society a possibility； as they now are a fact before us。 So much for this parenthesis of the tongue…scraper； which helped to save the young colony from a much more serious scrape； and may save the Union yet； if a Presidential candidate should happen to be taken sick as Massasoit was； and his tongue wanted cleaning；which process would not hurt a good many politicians； with or without a typhoid fever。
Again； see how the 〃bilious〃 theory works in every…day life here and now； illustrated by a case from actual life。 A youthful practitioner； whose last molars have not been a great while cut； meets an experienced and noted physician in consultation。 This is the case。 A slender； lymphatic young woman is suckling two lusty twins； the intervals of suction being occupied on her part with palpitations； headaches； giddiness； throbbing in the head； and various nervous symptoms； her cheeks meantime getting bloodless； and her strength running away in company with her milk。 The old experienced physician； seeing the yellowish waxy look which is common in anaemic patients； considers it a 〃bilious〃 case； and is for giving a rousing emetic。 Of course； he has to be wheedled out of this； a recipe is written for beefsteaks and porter； the twins are ignominiously expelled from the anaemic bosom； and forced to take prematurely to the bottle； and this prolific mother is saved for future usefulness in the line of maternity。
The practice of making a profit on the medicine ordered has been held up to reprobation by one at least of the orators who have preceded me。 That the effect of this has been ruinous in English practice I cannot doubt； and that in this country the standard of practice was in former generations lowered through the same agency is not unlikely。 I have seen an old account…book in which the physician charged an extra price for gilding his rich patients' pills。 If all medicine were very costly； and the expense of it always came out of the physician's fee； it would really be a less objectionable arrangement than this other most pernicious one。 He would naturally think twice before he gave an emetic or cathartic which evacuated his own pocket； and be sparing of the cholagogues that emptied the biliary ducts of his own wallet； unless he were sure they were needed。 If there is any temptation； it should not be in favor of giving noxious agents； as it clearly must be in the case of English druggists and 〃General Practitioners。〃 The complaint against the other course is a very old one。 Pliny； inspired with as truly Roman horror of quackery as the elder Cato；who declared that the Greek doctors had sworn to exterminate all barbarians； including the Romans； with their drugs； but is said to have physicked his own wife to death； notwithstanding；Pliny says； in so many words； that the cerates and cataplasms； plasters； collyria； and antidotes； so abundant in his time； as in more recent days； were mere tricks to make money。
A pretty strong eddy； then； or rather many eddies； setting constantly back from the current of sober observation of nature； in the direction of old superstitions and fancies； of exploded theories； of old ways of making money； which are very slow to pass out of fashion
But there are other special American influences which we are bound to take cognizance of。 If I wished to show a student the difficulties of getting at truth from medical experience； I would give him the history of epilepsy to read。 If I wished him to understand the tendencies of the American medical mind； its sanguine enterprise； its self…confidence； its audacious handling of Nature； its impatience with her old…fashioned ways of t
